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Treatment of Postpartum Hemolytic Uremic Syndrome With Plasma Exchange

Cory D. Spencer, MC; Franklin M. Crane, MC; Joan R. Kumar, MC; Barbara M. Alving, MC
JAMA. 1982;247(20):2808-2809. doi:10.1001/jama.1982.03320450042030.
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POSTPARTUM hemolytic uremic syndrome (HUS) is a rare disease with a reported mortality of 61%.1 Heparin and antiplatelet agents are of unproved benefit in the treatment of HUS.2,3 Recently Remuzzi and co-workers4 demonstrated reversal of hemolysis and thrombocytopenia within 48 hours after a single plasma exchange in two middle-aged women with severe hypertension and HUS. The present report describes the treatment of HUS in a postpartum patient with plasma exchange alone, documenting the promptness with which it reversed hemolysis and thrombocytopenia in this setting.

Report of a Case  A 23-year-old woman (gravida 4, para 2, abortus 1) was seen at another hospital in her 34th gestational week with acute abdominal pain. She was preeclamptic. Her hematocrit reading was 20% and platelet count was 113,000/cu mm. She received packed RBCs and 2 units of fresh-frozen plasma. Five hours after admission she was spontaneously delivered of a stillborn infant


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